Individual
MR. BRAD WOLCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
340 GREAT OAKS DRIVE, DAYTON, OH 45403
(937) 267-6973
Mailing address
340 GREAT OAKS DRIVE, DAYTON, OH 45403
(937) 267-6973
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
SY372426
OH
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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